TMC PULSE

t m c » p u l s e | j u n e 2 0 1 6 34 A New Kind of Care Health care providers from around the Texas Medical Center have come together to give quality care to special needs patients who have aged out of the pediatric system T here are currently 53 million adults with intellectual and developmen- tal disabilities in the United States population, according to the Centers for Disease Control and Prevention. Due to a lack of trained health care profession- als, the majority of this population are unable to find quality medical care, and sadly many go for prolonged periods of time without health care as a result. Cynthia Peacock, M.D., director of the Transition Medicine Clinic at Baylor College of Medicine, received her medical degree and residency train- ing from Baylor College of Medicine. After her medical training, she returned to Baylor and became the combined internal medicine-pediatric residency program director. While in this posi- tion, she recognized a gap in care for people with intellectual and develop- mental disabilities once they aged out of the pediatric health care system. "While I was the residency direc- tor at Baylor, several of my pediatric colleagues began telling me about the number of individuals coming out of the pediatric health care system impact their disease status. The combi- nation of the two can affect their ability to find health care providers who are willing to care for them," Peacock said. By partnering with numerous health care providers from around the Texas Medical Center, Peacock is able to offer her patients a complete medical home and primary care. In addition to primary care, patients of the Transition Medicine Clinic at Baylor can receive help from social workers, have proce- dures done, see specialists and even have optical and dental care arranged for them. "I think our clinic model demon- strates that if you engage all of these people from different fields and get them to work together, you can really provide the best care for this population of patients, and it has been life-chang- ing for our patients," Peacock said. Many of the patients from the Transition Medicine Clinic at Baylor are sent to the University of Houston College of Optometry for optometry services. The school provides a clinic specifically for adults with disabilities called SNAPS (Special Needs Adult and Pediatric Service). The clinic cares for teens and adults with a variety of disabilities and with different levels of cognitive aptitude. who could not find adult health care," Peacock said. Adults with disabilities such as autism, Down syndrome and cerebral palsy suffer from many health issues that require constant medical care. Fifty percent of people with Down syndrome have congenital heart disease and many also suffer from thyroid disease, lung disease and gastrointestinal issues. "Many times their anatomy is very different than that of a neuro-typical person," Peacock said. "Generally only pediatricians are trained to work with people with developmental disabilities and understand the physiology differ- ences they present with." Many of the patients with intellec- tual and developmental disabilities also suffer from behavior disorders that make seeing a doctor in a tradi- tional clinic setting very challenging. Whether it be a sensitivity to light, fear of elevators and crowds or even sitting still in a chair, it can be very hard for these patients to be seen by community physicians because of the time and accommodations it takes for them to be comfortable. "Most physicians do not have time to accommodate this patient population and also have not been trained with the techniques to help make them comfort- able in a clinic setting," Peacock said. In 2005, Peacock opened the Transition Medicine Clinic at Baylor College of Medicine to provide medical care and social support services to the growing population of adolescents and young adults with a chronic childhood illness or disability as they move from pediatric to adult health care. Today, the clinic serves 700 patients with complex childhood conditions from around the Houston community and utilizes the resources and talent the Texas Medical Center has to offer to provide the best care possible for patients. "The patients that I see at my clinic are significantly impacted by their childhood conditions. Not only do many have intellectual and develop- mental disabilities, but they also have numerous social determinants that B y B r i t n i N . R i l e y MANY PATIENTS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES ALSO SUFFER FROM BEHAVIOR DISORDERS THAT MAKE SEEING A DOCTOR IN A TRADITIONAL CLINIC SETTING VERY CHALLENGING. I think our clinic model demonstrates that if you engage all of these people from dierent fields and get them to work together, you can really provide the best care for this population of patients, and it has been life-changing for our patients. — CYNTHIA PEACOCK, M.D. Director of the Transition Medicine Clinic at Baylor College of Medicine

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